Initial case series experience with robotic-assisted transanal minimally invasive surgery performed with da Vinci single-port system for the excision of rectal cancer.

Autor: Woo JS; Department of Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, 15, Daehakbyeongwon-ro, Dong-gu, Ulsan, South Korea., Cho MJ; Department of Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, 15, Daehakbyeongwon-ro, Dong-gu, Ulsan, South Korea., Park IK; Department of Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, 15, Daehakbyeongwon-ro, Dong-gu, Ulsan, South Korea., Im YC; Department of Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, 15, Daehakbyeongwon-ro, Dong-gu, Ulsan, South Korea., Kim GY; Department of Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, 15, Daehakbyeongwon-ro, Dong-gu, Ulsan, South Korea., Park DJ; Department of Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, 15, Daehakbyeongwon-ro, Dong-gu, Ulsan, South Korea., Yang S; Department of Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, 15, Daehakbyeongwon-ro, Dong-gu, Ulsan, South Korea. ssyang913@gmail.com.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Nov; Vol. 38 (11), pp. 6762-6770. Date of Electronic Publication: 2024 Aug 19.
DOI: 10.1007/s00464-024-11142-w
Abstrakt: Background: Transanal minimally invasive surgery (TAMIS) is widely used for rectal lesion excision. Robot-assisted TA TAMIS (R-TAMIS) may improve surgical ergonomics. The introduction of the da Vinci Single-Port (SP) robot, designed for endoluminal surgery, has brought new possibilities. Our primary objective herein was to assess the technical and oncological feasibility and efficacy of Single-port robotic TAMIS (SPR-TAMIS) in rectal cancer excision. The secondary objective was to analyze the perioperative outcomes.
Materials and Methods: We included 14 consecutive patients with rectal cancer who underwent SPR-TAMIS between April 2021 and February 2023. Patient data, surgical details, and clinical outcome data were collected to assess the safety and feasibility of SPR-TAMIS.
Results: The median participant age was 72 years, and full-thickness excision was performed without specimen fragmentation in all cases. The median tumor diameter was 2.7 cm, positioned between 10 cm proximally and 7 cm distally from the anal verge. Negative margins were achieved in 93% of cases, with one case requiring further resection. The median operative time was 175 min, and the median hospital stay was 5 days. No intraoperative conversion from SPR-TAMIS to laparoscopic or conventional transanal excision was required. No mortalities or major postoperative complications occurred; however, one patient (7.1%) experienced minor morbidity manifesting as wound dehiscence (Clavien-Dindo grade I). No recurrence was observed during the 24-month follow-up.
Conclusions: In our early experience, SPR-TAMIS is a safe and feasible surgery for selected early stage rectal cancers, offering enhanced visualization and stable maneuverability transanally. This platform may have potential advantages for the excision of larger or more proximal lesions.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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